Top-up health cover costs up 5%

THE cost of top-up health insurance rose by an average 5% at the beginning of 2010.

This is because the state is asking insurers to cover a bigger burden of health expenses, according to the head of La Mutualité Française, Jean-Pierre Davant.

The companies under this group insure 38 million people in France.

When you visit a doctor or other medical personnel in France you often pay up front.

The state reimburses a set percentage of this and a top-up policy covers the rest, depending on the level of cover.

Mr Davant says the rise in top-up costs is needed due to an extra €2 on the daily charge for being in hospital (the forfait hospitalier which is not reimbursed by the state), costs associated with swine flu and a drop in the reimbursement rate for some medicines.

Top-up insurance, as its name suggests, "tops up" your state reimbursement. It pays back the part that the state does not cover. Such policies are optional but highly recommended.

State reimbursements vary according to the specific act or medicine and personal factors, such as whether you visit via your GP, if the illness is a serious long-term one or if you are pregnant.

For example, the basic cost of seeing a GP is €22 and the state reimburses 70% of this. (If your GP charges more, the state still only reimburses 70% of €22.)

It varies whether or not you have to pay up front.

For example, at the doctor's you would pay €22 up front and hand over your carte vitale (state medical card) which the doctor uses to record the payment; the state then reimburses the 70% into your bank account.

With prescribed medicines, you pay nothing to the pharmacist for the state-reimbursed part and they claim it back from the state.

If you give the health professional/pharmacy etc details of your top-up provider this can be linked directly to your carte vitale to process the claim automatically (télétransmission). This means you pay nothing at all at the till.

In the case of GPs the full cost of the consultation is paid up front but reimbursed later by the state and insurer.

If you cannot set up télétransmission with your carte vitale you will have to fill in forms for your insurer.

A survey by insurance group Jalma found health costs for the average family have risen 50% since 2001 once extra charges were taken into consideration.